切换至 "中华医学电子期刊资源库"
高级检索
中华诊断学电子杂志

中华诊断学电子杂志 ›› 2017, Vol. 05 ›› Issue (01) : 18 -21. doi: 10.3877/cma.j.issn.2095-655X.2017.01.005

所属专题： 文献；

影像学诊断研究

超声支气管镜引导下经支气管针吸活检术在纵隔肺门占位性病变中的临床应用
廖慧1, 王导新1,†(), 李长毅1, 李升锦1, 兰箭1   
  1. 1. 400010　重庆医科大学附属第二医院呼吸科
  • 收稿日期:2016-11-06 出版日期:2017-02-26
  • 通信作者: 王导新
  • 基金资助:
    国家自然科学基金(81670071)

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal and hilar lesions

Hui Liao1, Daoxin Wang1,†(), Changyi Li1, Shengjin Li1, Jian Lan1   

  1. 1. Department of Respiratory, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, china
  • Received:2016-11-06 Published:2017-02-26
  • Corresponding author: Daoxin Wang
  • About author:
    Corresponding author: Wang Daoxin, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

廖慧, 王导新, 李长毅, 李升锦, 兰箭. 超声支气管镜引导下经支气管针吸活检术在纵隔肺门占位性病变中的临床应用[J]. 中华诊断学电子杂志, 2017, 05(01): 18-21.

Hui Liao, Daoxin Wang, Changyi Li, Shengjin Li, Jian Lan. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal and hilar lesions[J]. Chinese Journal of Diagnostics(Electronic Edition), 2017, 05(01): 18-21.

目的

探讨超声支气管镜引导下经支气管针吸活检术(EBUS-TBNA)在肺门及纵隔占位性病变中的应用、诊断价值及安全性。

方法

收集重庆医科大学附属第二医院呼吸科2014年10月至2016年9月，胸部CT检查显示纵隔、肺门淋巴结肿大和(或)胸腔内肿物并行EBUS-TBNA检查的246例患者临床资料，对所有行EBUS-TBNA检查患者的细胞学或病理学检查结果、诊断阳性率及并发症发生情况进行回顾性分析。

结果

246例患者EBUS-TBNA后标本病理结果：诊断为恶性肿瘤130例，良性疾病72例，可疑恶性肿瘤26例，诊断未明者18例。恶性肿瘤中小细胞肺癌共45例，非小细胞肺癌共39例，无法确切分型者42例，转移性神经内分泌癌1例，B型淋巴瘤2例，原发性纵隔肉瘤1例。良性疾病中非特异性炎症者22例，纵隔囊肿2例，肺脓肿1例，肺囊肿伴放线菌感染1例，尘肺8例，纵隔淋巴结结核27例，结节病11例。

结论

EBUS-TBNA对不明原因的肺门、纵隔淋巴结肿大或肺门、纵隔旁占位病变的诊断具有重要价值，对肺门、纵隔少见疾病的诊断亦是一种重要的辅助检查手段。

关键词: 支气管镜检查, 超声检查, 活组织检查，针吸, 诊断
Objective

To investigate the application, diagnostic value and safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in hilar and mediastinal lesions.

Methods

A total of 246 patients with thoracic computed tomography (CT) examinations showed mediastinal, hilar lymphadenopathy and/or pleural masses, which were examined for EBUS-TBNA in the department of respiratory medicine, Second Affiliated Hospital of Chongqing Medical University from October 2014 to September 2016.The results of cytology or pathology, the positive rate of diagnosis and the incidence of complications were analyzed.

Results

In the 246 patients, there were 130 cases of malignant tumors, 72 cases of benigh diseases and 26 cases of suspicious cancer, but 18 cases′ pathological diagnosis couldn′t be definite.In malignant tumors cases, 45 cases were small cell lung cancer and 39 non-small cell lung cancer, 42 cases of non-specific type, 1 case of metastatic neuroendocrine carcinoma, 2 cases of type B lymphoma and 1 case of primary mediastinal sarcoma.In benign disease, there were 22 cases of non-specific inflammation, 2 cases of mediastatic cyst, 1 case of pulmonary abscess, 1 case of pulmonary cyst with actinomycete infection, 8 cases of pneumoconiosis, 27 cases of mediastinal lymph node tuberculosis, and 11 cases of sarcoidosis.

Conclusions

EBUS-TBNA is of great value in the diagnosis of unexplained hilar, mediastinal lymph node enlargement or hilar and mediastinal epiphyseal lesions, especially for the diagnosis of sarcoidosis.It is also an important auxiliary examination to diagnosis of the rare hilar and mediastinal dieases.

Key words: Bronchoscopy, Ultrasonography, Biopsy, needle, Diagnosis
[1]
Silvestri GA,Gonzalez AV,Jantz MA, et al.Methods for staging non-small cell lung cancer：diagnosis and management of lung cancer, 3rd ed：American College of Chest Physicians evidence-based clinical practice guidelines[J]. Chest, 2013, 143(5 Suppl): e211S-e250S.
[2]
Tertemiz KC,Alpaydin AO,Karacam V, et al.The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracicmalignancy[J]. Surq Endosc, 2016: 1-8[Epub ahead of print].
[3]
Ozturk A,Demirci NY,Aktas Z, et al.EBUS may arise as an initial time saving procedure in patients who are suspected to have small cell lung cancer[J]. Clin Respir J, 2016: 22.
[4]
Yasufuku K,Chiyo M,Sekine Y, et al.Rea l-time endobronchial ultrasound-guided transbronchial needle aspiration of mediastinal and hilar lymph nodes[J]. Chest, 2004, 126(1): 122-1228.
[5]
胡洁,苏永华,殷霞, 等. 超声内镜引导针吸活检对肺门及纵隔占位性病变的诊断价值[J]. 中华医学杂志, 2012, 92(8): 528-531.
[6]
Navasakulpong A,Auger M,Gonzalez AV, et al.Yield of EBUS-TBNA for the diagnosis of sarcoidosis：impact of operator and cytopathologist experience[J]. BMJ Open Respir Res, 2016, 3(1): e000144.
[7]
Osinka K,Zielińska-Krawczyk M,Korczyński P, et al.Impact of endobronchial ultrasound guided transbronchial needle aspiration on diagnostic yield of bronchoscopy in patients with mediastinal lymph node enlagement[J]. Adv Exp Med Biol, 2016(911): 33-34.
[8]
Wang CH,Xu CC,Jiang JH, et al. Diagnosis of a rare primary pulmonary synovial sarcoma with endobronchial ultrasound-guidedtransbronchial needle aspiration[J]. Thorac Cancer, 2016, 7(6): 684-688.
[9]
史丽霞,杨洋,杜钟珍. 经支气管镜超声内镜针吸活检应用进展[J]. 国际呼吸杂志, 2011, 31(18): 1419-1422.
[10]
Wong M,Yasufuku M,Nakajima T, et al.Endobronchial ultrasound：new insight for the diagnosis of sarcoidosis[J]. Eur Respir J, 2007, 29(6): 1182-1186.
[11]
Nakajima T,Yasufuku K,Kurosu K, et al.The role of EBUS-TBNA for the diagnosis of sarcoidosis-comparisons with other bronchoscopic diagnostic modalities[J]. Respir Med, 2009, 130(12): 1796-1800.
[12]
Miliauskas S,Zemaitis M,Sakalauskas R. Sarcoidosis-moving to the new standard of diagnosis[J]. Medicina(Kaunas), 2010, 46(7): 443-446.
[13]
解桢,赵辉,周足力, 等. 支气管内超声引导针吸活检术在纵隔病变诊断及鉴别诊断中的应用价值[J]. 中国微创外科杂志, 2013, 13(4): 295-299.
[14]
Yasufku K,Chiyo M,Koh E, et al. Endobtonchial ultrasound guiedtransbronchial needle aspiration for staging of lung cancer[J]. Lung Cancer, 2005, 50(3): 347-354.
[15]
李辑伦,赵辉,隋锡朝, 等. 支气管内超声引导针吸活检术在Ⅰ、Ⅱ期胸部结节病诊断中的应用价值[J]. 中国微创外科杂志, 2015, 15(4): 325-332.
[16]
陈武飞,滑炎卿. 早期肺癌低剂量CT筛查的研究进展[J/CD]. 中华诊断学电子杂志, 2015, 3(3): 192-194.
[17]
Gupta D,Dadhwal DS,Agarwal R, et al.Endobronchial ultrasound-guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis[J]. Chest, 2014, 146(3): 547-556.
[1] 魏淑婕, 惠品晶, 丁亚芳, 张白, 颜燕红, 周鹏, 黄亚波. 单侧颈内动脉闭塞患者行颞浅动脉-大脑中动脉搭桥术的脑血流动力学评估[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1046-1055.
[2] 杨水华, 何桂丹, 覃桂灿, 梁蒙凤, 罗艳合, 李雪芹, 唐娟松. 胎儿孤立性完全型肺静脉异位引流的超声心动图特征及高分辨率血流联合时间-空间相关成像的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1061-1067.
[3] 张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1068-1073.
[4] 朱连华, 费翔, 韩鹏, 姜波, 李楠, 罗渝昆. 高帧频超声造影在胆囊息肉样病变中的鉴别诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 904-910.
[5] 张梅芳, 谭莹, 朱巧珍, 温昕, 袁鹰, 秦越, 郭洪波, 侯伶秀, 黄文兰, 彭桂艳, 李胜利. 早孕期胎儿头臀长正中矢状切面超声图像的人工智能质控研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 945-950.
[6] 陈舜, 薛恩生, 叶琴. PDCA在持续改进超声危急值管理制度中的价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 974-978.
[7] 周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[8] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[9] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 844-848.
[10] 张丽丽, 陈莉, 余美琴, 聂小艳, 王婧玲, 刘婷. PDCA循环法在超声浅表器官亚专科建设中的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(07): 717-721.
[11] 罗刚, 泮思林, 陈涛涛, 许茜, 纪志娴, 王思宝, 孙玲玉. 超声心动图在胎儿心脏介入治疗室间隔完整的肺动脉闭锁中的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(06): 605-609.
[12] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[13] 袁媛, 赵良平, 刘智慧, 张丽萍, 谭丽梅, 閤梦琴. 子宫内膜癌组织中miR-25-3p、PTEN的表达及与病理参数的关系[J]. 中华临床医师杂志(电子版), 2023, 17(9): 1016-1020.
[14] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[15] 周婷, 孙培培, 张二明, 安欣华, 向平超. 北京市石景山区40岁及以上居民慢性阻塞性肺疾病诊断现状调查[J]. 中华临床医师杂志(电子版), 2023, 17(07): 790-797.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号